Possible Clues:

• Upset a Rhode Island girl carrying goods
• After endless hassle the night before, one enters in distress
• Trouble always returns, over one misjudged gag at first
• King George IV clings to throne, ultimately in era of trouble
• Distress of a good girl with smile mostly hidden
• Trouble with endless Viagra, get off tablet
• Distress in the street over horse from Ireland almost falling over
• Give gear mistakenly, causing distress
• Give rage in order to afflict
• Cause sadness by putting ricotta topping into a veggie dish ...